SIUT’s new Karachi facility for children offers hopes for better treatment

• Mariyam Bashir Dawood Children’s Hospital designed to provide expensive cardiac, urological services for free
• Rs10bn facility set to become operational later this year

KARACHI: Assisted by their loved ones, over 300 children wait for their turn at a hospital being developed at a fast pace in the old city area. Most of them seem visibly tired, sad and bored. But, as soon as the sound of music spreads and resonates within the hall, their eyes light up with surprise and excitement. They immediately turn their heads towards the reception desk where they see a pianist, instead of a nurse, demonstrating her extraordinary skills.

“Children love music. I play national songs and poems for them so they forget their illnesses and hardships, for a while,” Zainab Imran tells Dawn during a visit to the Mariyam Bashir Dawood Children’s Hospital, the brainchild of Dr Adib Rizvi and his team at the Sindh Institute of Urology and Transplantation (SIUT).

Imran, a graduate of Ida Rieu College for the Blind and Deaf, has been associated with the SIUT for over 20 years now, entertaining ailing children, the majority of whom hail from families struggling to survive and lacking access to essential services.

Today, they all are part of the SIUT family. Among them are: five-year Mavia, 12-year-old Fakhar Zaman, eight-year-old Laiba and two-year-old Zohaib.

“My grandson Mavia suffers from a kidney disorder. He is much better now after getting treatment at the SIUT for two years,” says Mariam Bibi.

Despite her old age, Mariam Bibi travels alone every three months by train to bring her grandson for a follow-up examination from the distant town of Rahim Yar Khan in Punjab to Karachi. Her relationship with the SIUT is quite old.

“Over two decades ago, I used to come here for my son’s treatment,” she recalls.

Like her, Zahoor, in his late 60s, looks after the medical needs of his little grandson who needs dialysis twice a week. He is 12-year-old now.

“I had to leave my hometown Buner, Khyber Pakhtunkhwa, and reside in Karachi to ensure Fakhar’s timely treatment. He has no one but me. His parents abandoned him after their separation,” he shares, sadly.

Laiba and Zohaib, both from Karachi, have just begun their journey with the SIUT — a major tertiary care institution known for providing quality healthcare free of cost.

The children are diagnosed with nephrotic syndrome — a serious condition in which the kidneys release excessive amounts of protein in urine, and lack of proper treatment can lead to complications including kidney damage. The symptoms such as swelling in various body parts and persisting weakness and sickness forced their parents to seek medical treatment.

Specialised paediatric care

Located near the SIUT’s main building on Chand Bibi Road, the 14-storey children’s hospital is designed to provide a complete continuum of care to children seeking cardiac, urological and nephrology services.

Currently, the process is underway to install latest equipment at the hospital, which will offer services for emergency, clinic rooms, complete diagnostics, including laboratories/blood bank, MRI, CT, lithotripsy, gamma camera, dialysis centre, critical care beds, five modular operating rooms, two cardiovascular operating rooms, two catheterisation labs (examination rooms with diagnostic imaging equipment used to treat heart conditions) as well as research and teaching spaces.

To address the community’s critical needs, outpatient services for cardiac patients were launched last year in November. The latest addition is nephrology and urology outpatient services opened last month.

The Rs10 billion project being built with philanthropic and government support is expected to become fully operational later this year.

“The project signifies SIUT’s continued commitment to ensuring quality health care as a fundamental right of every individual. Like the SIUT, patients here will be attended to on first come, first served basis only and receive high quality free medical cover,” says senior paediatric urologist Dr Sajid Sultan, who has been associated with the SIUT since 1986.

Explaining the need for a specialised paediatric centre, he said while children were being treated along with adults at the SIUT, the team felt the need for a separate facility, considering the growing number of patients presenting with complications, the availability of limited treatment facilities in Pakistan and the growing scope of paediatric specialties.

“Every year, around 80,000 to 100,000 children are born in Pakistan with congenital anomalies including those related to the heart, urinary tract and kidneys, which if left unattended can be life-threatening or may lead to disability.

“The prevalence of paediatric kidney stones, nephrotic syndrome and spinal defects is high in our country. Many children present to us with birth defects like posterior urethral valves. If they fail to get proper management, 20 per cent of these patients may experience renal failure.”

According to him, the access and options for specialised high quality care for these illnesses is limited in Pakistan.

In the private sector, the treatment may cost them anywhere from Rs500,000 to Rs3 million, a significant financial burden on most families.

The SIUT, Dr Sultan says, has been functioning as a centre of excellence for paediatric urology, nephrology and transplant in the region for a long time; hundreds of SIUT-trained doctors are now serving at different hospitals across the country while foreign faculty is regularly invited to upgrade and strengthen in-house expertise.

More than 100,000 paediatric urological surgeries, most of them complext, have been conducted at the SIUT in the last 20 years.

The children’s hospital, Dr Sultan points out, will not cater to patients with common illnesses such as diarrhoea. “We wanted to avoid replication of facilities. The city already has hospitals catering to these diseases. Therefore, affected patients will be referred to relevant health facilities after being provided supportive treatment at the emergency department here.”

Congenital heart defects

At the SIUT, the paediatric cardiac unit was launched in 2022. In a short time of less than four years, the experts have performed over 500 surgeries and 400 angioplasties. Preparations are underway to perform percutaneous valve replacement procedure that will be performed for the first time in Pakistan.

Explaining the urgent need for providing quality care in paediatric cardiology and heart surgery, Dr Babar Hasan heading the relevant unit at the hospital, says that heart defects are the most common type of birth defects worldwide.

“In Pakistan’s case, however, the vulnerability for congenital heart defects is much higher given our high under-five mortality and birth rates, higher numbers of acutely malnourished mothers as well as increased prevalence of cousin marriages (among other factors).

“Four countries, India, Pakistan, China and Indonesia, account for at least half of the global child population with congenital heart defects,” Dr Babar Hasan heading the paediatric unit said, explaining as to why the specialty was chosen for providing treatment.

Researches, he says, have also linked higher vulnerability to congenital heart defect/s to increase in temperature.

Nephrology OPD

Around 300 to 400 patients arrive at the recently launched nephrology OPD services organised once a week at the SIUT children’s hospital.

“Only 18 per cent patients are from Karachi while 62pc are from the interior parts of Sindh. We also get patients from Balochistan and Punjab,” shares Dr Ali Asghar Lanewala heading the paediatric nephrology unit.

The SIUT, Dr Lanewala says, gets its strength from the poor, the most deprived segments of the society and donors, many of them want to remain anonymous.

“While we want to spread our wings and provide the best facilities to more patients, we want to grow as a family, holding onto the relationship once built, and keeping our tradition of providing free medical care with dignity alive.”

According to officials, the hospital is expected to cater to 16,000 inpatients per year whereas 500 patients are expected to report at clinics per day.

The 20-bedded emergency facility will be providing safe, effective and immediate care. The dialysis centre will add capacity for 100,000 sessions per year using the modern equipment for improved patient outcomes.

Published in Dawn, April 13th, 2025